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Intradialytic exercise in hemodialysis patients: a systematic review and meta-analysis.

Abstract：

BACKGROUND AND OBJECTIVE:Hemodialysis (HD) patients are more inactive, leading to poor functional capacity and quality of life; this may be reversed with intradialytic exercise training. To systematically evaluate the efficacy and safety of intradialytic exercise for HD patients, we conducted a meta-analysis of the published randomized controlled trials. DATA SOURCES AND METHODS:Medline, Embase, and Cochrane Central Register of Controlled Trials were systematically searched up to February, 2014. The reference lists of eligible studies and relevant reviews were also checked. RESULTS:24 studies of 997 patients were included. Compared with control, intradialytic exercise significantly improve Kt/V (SMD = 0.27, 95% CI 0.01-0.53), peak oxygen consumption (VO(2peak)) (SMD = 0.53, 95% CI 0.30-0.76), and physical performance of physical function of life (SMD = 0.30, 95% CI 0.04-0.55). However, no significant improvements were found in the mental function of life. There was no significant difference with respect to musculoskeletal and cardiovascular complications between the intradialytic exercise groups and control groups. Further subgroup analysis found that, when the trial duration was more than 6 months, the intervention had significant effects on VO(2peak) (SMD = 0.89, 95% CI 0.56-1.22). However, when the trial duration was less than 6 months, the change of VO(2peak) was not significant (SMD = 0.19, 95% CI -0.13 to 0.51). CONCLUSION:Intradialytic exercise can improve Kt/V, VO(2peak), and the physical quality of life, and intradialytic exercise is safe for HD patients. Therefore, we put forward the suggestion that clinical guideline be updated to inform clinicians on the benefits of intradialytic exercise on HD patients.

journal_name

Am J Nephrol

journal_title

American journal of nephrology

authors

Sheng K,Zhang P,Chen L,Cheng J,Wu C,Chen J

doi

10.1159/000368722

subject

Has Abstract

pub_date

2014-01-01 00:00:00

pages

478-90

issue

5

eissn

0250-8095

issn

1421-9670

pii

000368722

journal_volume

40

pub_type

杂志文章,meta分析,评审

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